Post-operative Care Following Haemorrhoidectomies - The Post Hemorrhoidectomy Recovery Period
This article is all about hemorrhoidectomy recovery. It is going to have a look at what you should expect after having surgery to remove your haemorrhoids.
Your doctor will likely explain about the hemorrhoidectomy recovery period beforehand, but sometimes there are questions you don’t think to ask at the time, or problems that arise after the hemorrhoidectomy has been performed, so we thought it would be helpful to give you some extra information.
What the hemorrhoidectomy operation entails
This is the biggest operation you can have to remove a haemorrhoid.
It involves removing the pile or piles as well as some of the bowel wall where they come from, then either sewing the wound up or leaving it open and then allowing it to heal.
It can be done under a local anaesthetic and a sedative.
Some people (very understandably) don’t like being awake during the hemorrhoidectomy and prefer to have a general anaesthetic, but on the whole, doctors will be probably reluctant to use one if it can be avoided.
This is because a general anaesthetic is almost like another operation in itself, and adds to the complexity of the hemorrhoidectomy as well as the time it takes to recover.
Some people, particularly those who are older or have heart complaints, may be better advised to avoid a general anaesthetic altogether for their hemorrhoidectomy, but your doctor will be able to give you specific advice to your case as much will depend on your health.
The hemorrhoidectomy will only be performed for very large piles, probably ones that have been present for a long time and reached grade three or four.
You can find more information about this operation on the page http://www.hemorrhoidshemroids.com/hemorrhoidectomy-hemorhoidectomy.html
What happens afterwards? The hemorrhoidectomy recovery process.
Hemorrhoidectomy recovery from the Anaesthesia:
First of all, you need to recover from the anaesthetic.
If you’ve just had a local anaesthetic, you’ll be able to go home once the sedative has worn off and you feel ready to leave. This will take longer if you have had a general anaesthetic, but you’ll probably be able to go home again on the same day as the hemorrhoidectomy.
Hemorrhoidectomy recovery also involves resting:
The hemorrhoidectomy has involved removing a piece of your bowel. The bowel is a very active organ, and it’s not something that you can really rest, as you would if you’d had an operation on your joints.
Actually, too much rest after an operation may actually increase your recovery time, particularly for joint operations!
Hemorrhoidectomy recovery normally requires time off work:
Following a hemorrhoidectomy, the recovery should involve a little time off work (about a week or so, but your doctor can advise you on what’s right for you), and you should take it a little easy on yourself, try to remain active whilst you recuperate.
Hemorrhoidectomy recovery, pain and the need for pain relief:
You’ll probably be given a number of medications to help with your hemorrhoidectomy recovery.
First of all, you’ll be given painkillers.
As your bowel needs to keep working, and also now has a wound in it, it is almost certainly going to be quite sore at first, and the painkillers will help to keep this in check.
The pain ought to get less as the wound heals over, and that’s a fairly fast process - everything should be back to normal, and pain-free, within two to three weeks.
The pain ought to get less over this time as well. One of the advantages of this operation is that it totally removes the haemorrhoids, so all the symptoms and problems they cause should be gone.
Hemorrhoidectomy recovery and the need for stool softeners:
You’ll also get some medication to soften your stool, allowing you to pass it more easily and with less disturbance to the operative wound.
This reduces the pain for you and lets the wound get on with healing without stopping a normal bowel habit.
For similar reasons, you should make sure you drink plenty, at least a litre and a half of water every day. This also helps keep your stools soft and easy to move.
Hemorrhoidectomy recovery and the reintroduction of medication:
If you’ve been asked to stop any of your normal medications before the operation, check with your doctor when you should start them up again.
If you usually take certain medications for your haemorrhoids, you may find you don’t need them in the same way any more, so it’s especially important to find out about them.
How do you know if something bad is happening? Knowing when things are going wrong during the hemorrhoidectomy recovery.
This can be hard to judge. If you’ve been told that you’ll experience pain afterwards, how much is the ‘right’ amount?
If you’ve been told that you may experience a little bleeding, when is it enough to go back and ask?
Many people are a little unwilling to approach doctors if they think the problems are trivial or unimportant, and many doctors don’t like to get pestered with mundane things! But equally, all doctors would rather be asked about something than miss a potentially serious problem, so as a basic rule of thumb, if something worries you, you should ask.
That said, remember what you’ve already been told before the operation - it will probably be a couple of weeks before everything is totally back to normal, and you will almost certainly find the site of the operation is painful at first.
Opening your bowels may also make the pain worse.
Try not to panic if things aren’t ideal immediately!
You may also have been told of some of the risks and commonest side effects, and your doctor can tell you what to expect if any of them occur.
All operations, including hemorrhoidectomies, have risks and side effects associated with them.
The main ones are that the wound doesn’t close up properly, and may either bleed or get infected, or it heals up in such a way that the scar causes a problem (for example, restricting the bowel or blocking off an anal gland).
Here are some broad suggestions to help you know when to go and seek help during the hemorrhoidectomy recovery process:
(Before leaving the hospital, make sure that you have a way of getting a message to the doctor who performed the operation, either by phone or through their office, just in case you start to feel something is going wrong. If not, get in touch with your own doctor as soon as you can, if you need to. )
1.. If you are in consistent severe pain, or if you are experiencing a lot of bleeding, seek help.
2.. If the area around the operative site becomes more red, swollen, hot and painful than it was to start with, you may have an infection in the wound, for which you should seek help.
Bear in mind that any wound will always be hot, swollen, red and sore, as that inflammation is the side effect of the body’s natural healing response to injury. But if it gets worse, that means something isn’t right.
3.. If you are finding pus or mucus nearby it or in your stool, especially if it smells very unpleasant or unusual, seek help.
There may be an infection, or the operation may have caused one of your anal glands to become blocked - these are glands that are present around the anus and produce mucus to help stool slide through. If they get blocked either by scarring or by inflammation, the mucus has to go somewhere else, and the pressure build up that results can cause an abcess (a blocked-off capsule of fluid or puss inside the wall of the bowel) or a fistula (an inappropriate joining between one space in the body and another), both of which can be sorted out quickly with surgery.
4.. And if after two or three weeks are up and you are no better than you were just after the operation, go back to your doctor and ask why.
Your doctor will probably have arranged a follow-up appointment anyway, so that they can reassure themselves that they have, in fact, treated your haemorrhoids as they intended to!
Hemorrhoidectomy Recovery in Summary
Any hemorrhoidectomy or operation takes time to get over, and may have unforeseen consequences. Most of the time, your surgeon will prepare you well beforehand by telling you what to expect, and should explain the risks to you as well.
Remember, don’t be afraid to ask questions! Most of the infections or problems that occur during or as a result of surgery can be cleared up pretty quickly, but not if you let them be.
It’s much easier to get over asking a silly question than it is to get over a serious infection or a wound that isn’t healing, or to sit at home worrying.
At the end of the day, though, using your common sense is the best thing you can do (and what most of the advice your doctor will give you amounts to, at the end of the day). If you feel something doesn’t feel right, it probably isn’t, and your doctor would rather know about it than not.
Main write by Dr. James D. Hogg, (BSc Oxon, MBBS & BA Hons), medical doctor, and minor rewrite by D S Urquhart.
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